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[Nellf]

Ladies, I need some advice.  Currently taking 200mg utrogestan vaginally.  As I've tried the oral route, and it seems to affect my mood.  My GP is convinced that my low mood is not related to progesterone, which I'm convinced it is.  Still feeling low on the utrogestsn and not sure where to go next my Gp and Private meno consultant think I'd be a prime candidate for the coil.  On the side I've been taking sertraline since my late 40's.   Prescribed to me for severe PMT.  My GP upped my dose to 200mg and it did nothing.  Speaking to my GP on Friday about perhaps changing my antidepressants before even contemplating having a coil fitted.  At least I can rule some things out.  I'm so scared ro have a coil fitted in case it dosent suit.  Any advice please.  I just want to feel like my old self again. 

[CLKD]

Morning. It's The Change - does what is says on the tin  - often throwing up symptoms that no one expected including GPs!

The coil can be removed if it doesn't suit.  MayB put 'mirena coil' into the search box on the Forum to see the threads that will pop up.  Make notes.

How was your PMT?  How old R U, more or less ;-) ?  The National Association for Pre-menstrual Syndrome [NAPS] gave me a lot of advice when I was in my 30s [now 69].  Eating every 3 hours to ease anxiety surges was the main one.

Progesterone can affect women, which the menopause consultant should be aware of. 

Let us know how you get on?

[SarahT]

Morning Nellf,

Although I am perimenopausal, I can just say how progesterone worked best for me. I did not tolerate utrogestan at all,the instability it gave me as an ' on-off process throughout the month. So I switched to mirena coil. I find this gives me a more level release of progesterone during the entire month.
It took about 3 months tho settle, spotting and light bleeds,but it seems to suit me best.

I have had a life long problem.with severe pms, and early this year it got to scary levels, black moods, suicide thoughts. Apparently peri hormones can greatly worsen pms. Working with an understanding gp I upped my patches to 125, and added in a low dose AD, initially to use on the run up to my period ( no bleeds as on coil,bonus for me) but I still got horrific pms until The high dose settled.   The AD made a better difference too, so I take a low dose all month. Improved my life greatly.

Maybe the Sertraline is no longer affective for your needs. I am sorry but a lot of hrt mistrial and error. Add fluctuating hormones and we do seem to have to adapt as well. I wish you well

I agree it may be better if you tried to sort one thing at a time so you give each change time to work.

[CLKD]

Some ADs can poop out when the brain becomes used to them.  I've had several since 1988, each lasting long enough to give relief.

[Nellf]

Thank you ladies.  I guess its trial and error.  I'm 57 and 5 years post menopausal.  My PMS was quite severe.  Only getting relief when my period arrived.  I guess getting the coil will be trial and error too.  I think I'm just scared to try it incase I have a bad reaction.  I think I am maxed out on the sertraline and a change may help.  Just want to feel a bit better and understand it may take time.  This form is invaluable.  It provides support and advice.  Thank you ladies.  Onward and upwards.

[CLKD]

Think back to why you began HRT initially?  Has it helped at all? 

That was true PMS if symptoms stopped when the bleed started. Which do you think would be best: the coil can be inserted soon, whereas a change of AD might take a while to kick in, especially if you are advised to wean off the Sertraline. 

Perhaps put 'mirena coil' into the search box.

[SarahT]

Hi again Nellf,

Well, we are the same age then, even if I am still peri. 😠 I had the mirena fitted just about a year ago. I was also on Sertraline prior to starting hrt,but now am on a very low dose of Mirtazapine, helps.with the anxiety, general moods and bonus of helping me fall asleep better too.

It is sadly a bit of trial and error, which is hard when we are having tough times and we just need to feel better, we deserve that.

CLKD makes a good point that the Dr may want to wean you off the Sertraline first. Make some notes before your appt, questions and advice, both about the ADa.and the possibility of the coil. Without fail I come out of an appt and realise so had forgotten to ask stuff.

Take care

[Nellf]

CLKD, the estrogen patches have helped a lot.  Reduced sweats and anxiety.  I feel that I could be quite happy with estrogen therapy only.  But as I still have a womb, need to have some progesterone.  Quite frankly I'd opt for a hysterectomy if I could but that's a last resort apparently.  Just a bit all over the place at the moment.  My GP I feel.is becoming very dismissive at the moment.  I'll see how my call goes on Friday  I've got an appointment with my meno consultant at the end of October.
According to my Gp she needs guidance from my consultant  which i can totally understand, but as I've just paid £127 for a private prescription for utrogestan pessaries it can get costly.  Why are so many women having to private.  Surely we should have some menopause specialists that GPs can consult with on the NHS. 

[CLKD]

There are NHS Menopause clinics but I don't think that many GPs are aware!   Pity that the British Menopause Society doesn't kick  information into all GP Surgeries!!!!

If U wish for a hysterectomy this should be your choice to at least discuss with a Gynaecologist.  Better to discuss which replacement suits B4 surgery, as they don't know much either!

[Nellf]

So after chatting with my GP this morning, I'm going to try Venlafaxine .  With a review in 6 weeks.  Here, we go again on the menopause rollercoaster :

[CLKD]

....... and breath.  Tnx for the update.  This may suit you really well, though when I am given something new, I prevaricate about 'what ifs' 

I'm a bit like that with new food too 

[Nellf]

I'm just gonna roll with it

[CLKD]

I wouldn't be rolling anywhere with the ran that's falling  .  let us know how you get on?

I bet too if you suggested paying for a hysterectomy you wouldn't have any problems ......... it is major surgery though!  Cynic? Moi? 

[Hurdity]

Hi Nellf

Just to add - you do not need to pay privately for Utrogestan! They are available on NHS! I get them. Are you saying your GP won't prescribe them because she needs advice from the consultant? The 200 mg utro pessaries are not licensed any more for HRT though the 100 mg utrogestan is, so in fact even if your GP doesn't know enough about HRT to go off piste ( a little), she can prescribe you 2 x 100 mg utrogestan instead of the 200 mg pessaries, and you can use the 100 mg (oral) utrogestan vaginally in the same way - though it's more of a fiddle. This will only be until your specialist appointment comes through and if you run out - and if you want to use the pessaries then stress to your consultant that you want them prescribed this year so s/he will write to your gP accordingly.

I realise this is not what you asked but thought I should mention.

All the best with your appointment and working out the best progestogen option. I have only ever used utrogestan apart from an occasional dose of norethisterone tablets.

Hurdity x

[Mary G]

Nellf, if you have a history of PMS, I would strongly urge you to opt for a lower dose progesterone coil.  The Kyleena and the Jaydess can be used off licence according to the Chelsea and Westminster menopause clinic.  This is their fact sheet:

https://www.chelwest.nhs.uk/your-visit/patient-leaflets/medicine-services/levonorgestrel-intrauterine-system-with-hormone-replacement-therapy

Having had two Mirena coils in the past, I found that although most of the progesterone is confined to the womb, enough of it gets into your overall system to cause sides effects like breast pain which I have never had with other forms of progesterone.  When I hit the menopause, it caused dryness, infections (every year my actual smear tests were clear but I had some kind of infection) and overthinning of the womb lining because the progesterone dose was too high for me personally.

It's would assume the lower dose coils have fewer side effects.